Intestine as the Exclusive Site of Distant Metastasis From Lung Adenocarcinoma Detected on 18 F-FDG PET/CT.
Liqin Zhu, LiJun Peng, Fucen Liu et al.
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Case in brief
A 77-year-old man with lung adenocarcinoma underwent 18F-FDG PET/CT, which showed a moderately hypermetabolic pulmonary nodule and two intensely hypermetabolic intestinal lesions. Immunohistochemistry confirmed that the intestinal lesions were metastases from the pulmonary adenocarcinoma. The intestine was the exclusive site of distant metastasis. PET/CT also identified an ascending colon lesion, helping guide clinical management.
What made this case unusual
The intestinal lesions were the exclusive distant metastases, an uncommon pattern that can be mistaken for a primary gastrointestinal tumor.
Diagnostic / clinical pearl
In a patient with lung adenocarcinoma, intestinal lesions may represent metastases even when no other distant metastatic sites are identified; immunohistochemistry can establish their origin.
Why it matters
Whole-body 18F-FDG PET/CT can reveal additional intestinal lesions and help define the extent and origin of disease for clinical management.